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Cardiac left ventricular ejection fraction in men and women with schizophrenia on long-term antipsychotic treatment.
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2020 (English)In: Schizophrenia Research, ISSN 0920-9964, E-ISSN 1573-2509, article id S0920-9964(19)30612-7Article in journal (Refereed) Epub ahead of print
Abstract [en]

Patients with schizophrenia exhibit a higher cardiovascular mortality compared to the general population which has been attributed to life-style factors, genetic susceptibility and antipsychotic medication. Recent echocardiographic studies have pointed to an association between clozapine treatment and reduced left ventricular ejection fraction (LVEF), a measure that has been inversely associated with adverse outcomes including all-cause mortality. Cardiovascular magnetic resonance (CMR) is considered the reference method for LVEF measurement. The aim of the present study was to investigate the LVEF in patients with schizophrenia on long-term treatment with antipsychotics and healthy controls. Twenty-nine adult patients with schizophrenia on long-term medication with antipsychotics and 27 age-, sex- and body mass index-matched healthy controls (mean ages 44 and 45 years, respectively) were recruited from outpatient psychiatric clinics in Uppsala, Sweden. The participants were interviewed and underwent physical examination, biochemical analyses, electrocardiogram and CMR. Men with schizophrenia on long-term antipsychotic treatment showed significantly lower LVEF than controls (p = 0.0076), whereas no such difference was evident among women (p = 0.44). Specifically, clozapine-treated male patients had 10.6% lower LVEF than male controls (p = 0.0064), whereas the LVEF was 5.5% below that of controls among male patients treated with non-clozapine antipsychotics (p = 0.047). Among medicated men with schizophrenia, we found significantly lower LVEF compared to healthy individuals, suggesting the need of routine cardiac monitoring in this patient group. This is the first study showing a significant negative association between treatment with non-clozapine antipsychotics and LVEF.

Place, publisher, year, edition, pages
2020. article id S0920-9964(19)30612-7
Keywords [en]
Antipsychotics, Cardiovascular magnetic resonance, Clozapine, Left ventricular ejection fraction, Schizophrenia
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Medical and Health Sciences
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URN: urn:nbn:se:uu:diva-403856DOI: 10.1016/j.schres.2019.12.042PubMedID: 31959509OAI: oai:DiVA.org:uu-403856DiVA, id: diva2:1391707
Available from: 2020-02-05 Created: 2020-02-05 Last updated: 2020-02-06Bibliographically approved

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